BVFD, Mercy to test Community Paramedic program

Wednesday, August 27, 2014

It's the first of its kind in the state, right here in Bella Vista.

The Bella Vista Fire Department, in conjunction with Mercy Health, is on its way to a pilot program for a new line of care called Community Paramedic.

The idea is to focus on a patient's post-hospital care in an effort to reduce the number of hospital re-admissions, Jessica Eldred of Mercy media relations said.

"Providing post-hospital care is something that is gaining popularity across the U.S., and something we have been working on here at Mercy," she said.

The program works in cooperation with the patient, his or her doctor and specially trained Bella Vista paramedics.

When a patient is discharged from the hospital following an issue that has a high risk of recurrence, such as congenital heart failure or stroke, the patient can choose to participate in the program and have a paramedic come to his or her home to monitor vital signs, medications and heart rate.

Rather than a patient calling 911 for something like an uncertainty about how to administer medication, paramedics in the home can assist the patient in line with the patient's own doctor's advice.

The program would be supervised by both the ambulance service's medical director at Mercy, Dr. Brad Johnson, and the future Community Paramedic program's medical director, Dr. Stephen Goss, Fire Chief Steve Sims said.

The paramedic would arrive in a department-marked vehicle, but not an ambulance, to separate the visit from an emergency situation, Capt. Bill Hewlett said.

"There is a gap in health care from discharge to home health," Hewlett said.

It typically takes home health care 48 to 72 hours to begin, he said, adding this program is not intended to take the place of home health care or a patient's primary care doctor.

While paramedics are in the home, Hewlett said they can also perform fall and fire risk assessments and mitigation, including removing trip hazards and checking batteries in smoke detectors.

The elderly population in Bella Vista makes the city a good starting point for the program, Hewlett said. Even the topography adds to the need for the program.

For instance, Hewlett said, sometimes it is difficult for a patient to get to a follow-up doctor's appointment because of the city's hills when it snows. The medics won't transport the patient, but will help arrange a ride or even make appointments to see that the patient gets the appropriate care.

Hospital re-admissions cost the hospital more, the patients more and even the insurance companies more, Eldred said.

This program can help Mercy identify why re-admissions are happening and then follow up on those causes, she said.

"Just pursuing this is a smart thing to do. We want to be engaged in the discussion as they move forward," she said.

Six Bella Vista paramedics, two from each shift, will begin specialized training Sept. 1 through the University of Arkansas for Medical Sciences, paid for by Mercy, Hewlett said.

The program would not strain the department's regularly scheduled staff, Sims said.

"We're not pulling people off the shift; the demand isn't there for that," he said, adding that these types of visits wouldn't be critical events.

"This is a partnership and community service that hopefully we will be able to offer to our citizens next year," Sims said, adding there are details still needing to be ironed out before initiating the pilot.

Currently, paramedics are legally allowed to perform these duties, such as go to a home and check vitals, under their state-issued paramedic license. A change in state legislation that is in the works would make Community Paramedic a license in itself and therefore duties performed under the program could be billed to insurance, such as Medicare and Medicaid.

After the kick-off of the pilot, the program will be evaluated to see what benefit it provides the city and Mercy, Hewlett said. Patient participation in the program is on a voluntary basis, he added.

Mountain Home currently has a similar program through Baxter Regional Medical Center, which is a hospital-based emergency medical service, Hewlett said. Bella Vista would be the first non-hospital entity in the state to work in conjunction with doctors for this care.

"We did identify there is a need in Bella Vista," Sims said. "We are only talking about our people, the people that pay taxes in Bella Vista."

General News on 08/27/2014